In the short time since President Trump began his second term, there has been a rapid-fire barrage of executive orders conducted in a chaotic and reckless manner, creating anxiety, confusion, and uncertainty.
His executive orders have upended many aspects of the federal government including mass firings, layoffs, taking control of independent agencies, dismantling agencies, and making others dysfunctional. There is widespread anxiety in organizations dependent on the future of their threatened federal funding.
Health-related agencies have not been immune to these actions. The Centers for Disease Control and Prevention and the National Institutes of Health have become dysfunctional. This dysfunction has only been exacerbated by the appointment of Robert F. Kennedy, Jr. as Secretary of Health and Human Services who oversees these and other health agencies.
Policy development has been slowed or blocked. Vital programs at the CDC have been virtually eliminated or curtailed including the Office of Smoking and Health and the Childhood Lead Poisoning Prevention Program. Approval of CDC recommendations for new indications of existing vaccines has been delayed. Further, new vaccine approvals by the Federal Food and Drug Administration may be slowed by additional regulations including seasonal updates of the influenza and COVID vaccines.
Trump withdrew from the World Health Organization and directed the CDC, along with other health agencies, to cease communication with foreign health counterparts, hindering disease outbreak prevention and response.
The Trump administration silenced essential clinical and public health guidance and vital epidemiologic and disease-outbreak information, including archival data and datasets regularly provided to U.S. health-care providers and public health professionals. It pulled some agency web pages altogether.
Trump’s orders have suspended billions of dollars in biomedical research grants funded by the NIH and have withheld university research funding. NIH research dollars, for example, have been greatly reduced for Alzheimer’s and diabetes.
Agency censoring has targeted Diversity, Equity, and Inclusion, health equality, climate change, pollution, disability, and other issues. Censorship also extends to other considerations like vaccine uptake and even to sexually transmitted disease-treatment guidelines. All mass external communications must be consistent with Trump’s executive orders. There is little regard for scientific evidence.
The journal Nature reported that some studies submitted to journals by CDC authors have been ordered to be withdrawn; authors working on publications with external researchers have been instructed to remove their names when articles use language inconsistent to Trump’s executive orders. For other studies, certain language used must be stripped. Moreover, there are directives on what topics can be covered by research.
The Trump administration has resumed some communications and information regarding urgent public health needs, advisories, and regulatory and statutorily-required reports. Let’s hope that trend expands despite heavy administration oversight.
Underscoring these disturbing actions is a stunning editorial from the editors of the Journal of the American Medical Association, condemning the assault on scientific integrity and rigorously conducted scientific inquiry and “the silencing of U.S. scientific discourse.” JAMA has vowed to proceed with the highest standards for scientific and editorial integrity regardless of political pressures – an impressive display of courage.
Our country has entered dangerous waters.
Richard D. Feldman, M.D. is an Indianapolis family physician and former Indiana State Health Commissioner who served in the administration of Governor Frank O’Bannon.
Trump is doing exactly what he promised. Trimming the fat and government waste, saving us billions of dollars.